In celebration of International Youth Day, Global Health Youth Advisor discusses U.S. Government and USAID’s health programs impacting urban youth.
In 2010 I took a bike tour of Dar es Salaam’s slums. Over tea and chapattis my young guide told me he had lost both parents to AIDS. As the eldest, he had to ensure the education of his younger siblings. He dropped out of high school and migrated to Dar to work. Now at 24 with a good job, his siblings had finished school, and he was ready to return to school himself.
This glimpse of the vibrant yet chaotic life in Dar’s slums is one that we rarely see. I was struck by the large numbers of school-age youth in the streets working as petty traders: selling bananas, phone cards, sunglasses and pirated DVDs.
Dar is not unique. Rural to urban migration is accelerating, yet governments are ill-prepared to deal with it. In Timor L’este, I heard that that the capital’s population was growing by 10,000 people every year. Poorly serviced squatter settlements, slums, and camps are the norm in many cities, which are increasingly populated by youth seeking opportunities.
In Latin America and Asia, young female urban migrants outnumber young males. Many migrate to escape forced marriage or abusive relationships. UNICEF data from 12 countries show one in five migrant children aged 12–14 and half of those aged 15–17 move without a parent. Young urban migrants often find themselves in violent, stressful and unhealthy environments.
Migration displaces and separate youth from their homes and the protective structure and guidance of families and communities. Separation from sources of learning, recreation, and support; alteration of community routine, normalcy; and lack of positive alternatives contribute to the exploitation and abuse of young people. Young people also engage in risky behaviors, including sexual ones with dire consequences.
Developmentally appropriate reproductive health and family planning information and youth friendly services can prevent poor health outcomes, and can ensure young people receive adequate care and support for pregnancy, unsafe abortion, STIs/HIV, and violence.
Youth face many challenges to obtaining reproductive health services. Youth migrants are doubly challenged, since slums have limited health services. Urban programs must address and involve youth. Collaboration across sectors is essential to improving the health and opportunities of urban youth migrants.
U.S. Government and USAID’s health programs impacting urban youth:
Young Tanzanian women who migrate to the city are susceptible to the lure of a “sugar daddy.” The Fataki radio campaign (PDF) uses humor and familiar stories to foster dialogue around the dangers of intergenerational sex, empowering community members to intervene.
Fourteen years of civil war in Liberia displaced much of the population. Population Services International provides HIV and FP education in alternative high schools for youth now returning to Monrovia, with increased uptake of HIV testing and contraceptives.
One third of the 6 billion mobile subscribers are under the age of 30. Mobile for Reproductive Health (m4RH) is an on-demand SMS system with information about contraception and nearby clinics. Young Kenyans liked the simple language and confidentiality of the service. Tanzanian and Kenyan users reported increased contraceptive knowledge and use. FHI 360 and the Rwandan Ministry of Health are adapting m4RH with additional information for young people.
Globally, young people under 18 are considered children, and younger migrants are at especially high risk. The U.S. Government’s Action Plan for Children in Adversity recommends that U.S. Government assistance support and enable families to care for their children; prevent unnecessary family-child separation; and promote appropriate, protective, and permanent family care.
Learn more about youth programming at USAID. Join the conversation on Twitter using #IYD2013.